Pre-driving evaluation of a teen with attention deficit hyperactivity disorder and autism spectrum disorder

Department of Occupational Therapy, and Institute for Mobility, Activity and Participation, College of Public Health and Health Professions, University of Florida, PO Box 100164, Gainesville, FL 32610, USA.
Canadian Journal of Occupational Therapy (Impact Factor: 0.92). 02/2013; 80(1):35-41. DOI: 10.1177/0008417412474221
Source: PubMed


Vehicle crashes are the leading cause of death among teens, and those teens with attention-deficit/hyperactivity disorder and autism spectrum disorder (ADHD/ASD) may have a greater crash risk.
This case study compared the pre-driving skills of a teen with ADHD/ASD to an age- and gender-matched healthy control (HC).
Data were collected from performance on clinical tests and on a driving simulator.
The main impairments of the teen with ADHD/ASD were the ability to shift attention, perform simple sequential tasks, integrate visual-motor responses, and coordinate motor responses, whereas the HC demonstrated intact skills in these abilities. The teen with ADHD/ASD made 44 driving errors during the drive, and the HC made 17. The teen with ADHD/ASD had more lane maintenance, visual scanning, and speeding errors compared to the HC.
Teens with ADHD/ASD may have more pre-driving deficits and may require a certified driving rehabilitation specialist to assess readiness to drive, but a larger study is needed to confirm this.

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    ABSTRACT: Vehicle crashes are a leading cause of death among teens. Teens with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), or both (ADHD-ASD) may have a greater crash risk. We examined the between-groups demographic, clinical, and predriving performance differences of 22 teens with ADHD-ASD (mean age = 15.05, standard deviation [SD] = 0.95) and 22 healthy control (HC) teens (mean age = 14.32, SD = 0.72). Compared with HC teens, the teens with ADHD-ASD performed more poorly on right-eye visual acuity, selective attention, visual-motor integration, cognition, and motor performance and made more errors on the driving simulator pertaining to visual scanning, speed regulation, lane maintenance, adjustment to stimuli, and total number of driving errors. Teens with ADHD-ASD, compared with HC teens, may have more predriving deficits and as such require the skills of a certified driving rehabilitation specialist to assess readiness to drive.
    No preview · Article · Nov 2013
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    ABSTRACT: Adults with attention deficit hyperactivity disorder (ADHD) suffer from various impairments of cognitive, emotional and social functioning, which can have considerable consequences for many areas of daily living. One of those areas is driving a vehicle. Driving is an important activity of everyday life and requires an efficient interplay between multiple cognitive, perceptual, and motor skills. In the present study, a selective review of the literature on driving-related difficulties associated with ADHD is performed, seeking to answer whether individuals with ADHD show increased levels of unsafe driving behaviours, which cognitive (dys)functions of individuals with ADHD are related to driving difficulty, and whether pharmacological treatment significantly improves the driving behaviour of individuals with ADHD. The available research provides convincing evidence that individuals with ADHD have different and more adverse driving outcomes than individuals without the condition. However, it appears that not all individuals with ADHD are affected uniformly. Despite various cognitive functions being related with driving difficulties, these functions do not appear helpful in detecting high risk drivers with ADHD, nor in predicting driving outcomes in individuals with ADHD, since impairments in these functions are defining criteria for the diagnoses of ADHD (e.g., inattention and impulsivity). Pharmacological treatment of ADHD, in particular stimulant drug treatment, appears to be beneficial to the driving difficulties experienced by individuals with ADHD. However, additional research is needed, in particular further studies that address the numerous methodological weaknesses of many of the previous studies.
    Preview · Article · Sep 2015 · Journal of Neural Transmission
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    ABSTRACT: Volwassenen met attention deficit hyperactivity disorder (ADHD) hebben uiteenlopende cognitieve beperkingen, die een aanzienlijke invloed kunnen hebben op verschillende aspecten van het dagelijks leven. Een van deze aspecten is het besturen van een auto. Autorijden is een belangrijke activiteit in het dagelijks leven en vereist een adequate wisselwerking tussen verschillende vaardigheden en het op elkaar afgestemd zijn van verschillende functies. Dit artikel geeft een overzicht van studies die zich hebben gericht op de aan ADHD gerelateerde problemen met autorijden. Hierbij staan drie vragen centraal: 1) laten personen met ADHD in sterkere mate onveilig rijgedrag zien dan personen zonder ADHD, 2) welke cognitieve (dis)functies van personen met ADHD zijn gerelateerd aan onveilig autorijden en 3) kan farmaceutische behandeling het rijgedrag van adolescenten en volwassenen met ADHD significant verbeteren? Het beschikbare onderzoek levert overtuigend bewijs dat personen met ADHD gekenmerkt worden door meer negatief rijgedrag dan personen zonder ADHD. Het blijkt echter dat niet alle personen met ADHD op dezelfde manier zijn aangedaan. Hoewel verschillende cognitieve functies gerelateerd zijn aan rijvaardigheid, lijken deze functies noch bij te dragen aan het detecteren van high risk automobilisten met ADHD, noch aan het voorspellen van rijgedrag bij personen met ADHD. Farmaceutische behandeling van ADHD, in het bijzonder stimulerende medicatie, lijkt bevorderlijk voor de rijvaardigheid van personen met ADHD.
    No preview · Article · Jan 2016